Perform Under Pressure: Change the Way You Feel, Think and Act Under Pressure

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The overall stress response is relatively well-conserved, but the stressors themselves have not remained constant in the evolutionary history of species, nor have the potential outcomes of those stressors. High-pressure situations faced by some human populations today do not always come with life-or-death consequences (Monroe 2008). Instead, they are often lower-stakes but longer lasting and, rather than threatening physical well-being, as something like a predator does, threaten psychological or social well-being and may have many more potential outcomes than simply “fight” or “flee”. Because this shift is evolutionarily recent, however, we still respond as though all threats are physical ones. Thus, what was evolutionarily a beneficial tradeoff among the physical and cognitive systems impacted by the stress response might now represent a misalignment of priorities, since the stress response tends to prioritize physical readiness while neglecting complex cognition. Negative performance effects are likely due to this tradeoff in priorities (de Kloet et al. 1999; Nesse and Young 2000). The author, Dr Stephen Hearns, is a consultant in emergency medicine and leading member of Scotland’s EMRS – the Emergency Medical Retrieval Service. The EMRS, created in 2004, provides pre-hospital care in remote and austere locations. Dr Hearns has also been a member of the Arrochar Mountain Rescue Team for 20 years, has provided medical support to expeditions in challenging environments worldwide, as well as visiting sister retrieval services all over the world to learn and develop techniques for extreme emergency medicine.

Scott Boswell after bowling his sixth wide in the 2001 C&G Trophy final against Somerset. Photograph: Naden Rebecca Naden/PABeran MJ, Parrish AE (2012) Sequential responding and planning in Capuchin monkeys ( Cebus apella). Anim Cogn 15:1085–1094

According to a study by the RAND Center for the Study of Aging, nearly 50% of all retirees in the US continue to work part time, or return to work fully, after they have retired. One area in which individuals differ is in their response to stress. Pressure likely acts as an added stressor when trying to perform, so it seems logical that the stress response is involved in producing poor performance on cognitive tasks. Further, individual differences in how each individual responds to this stress in-the moment might be related to observed differences in performance. Individual responses to stress can differ both in their overall levels of stress as a result of their environment and life history and in how they cope with immediate, temporally transient stressors in the moment. Importantly, overall stress level and immediate reaction to in-the-moment stress often interact to produce observed behaviors and reactions. Therefore, when considering how individuals react to pressure, and which hormones related to stress might influence those reactions, it is important to understand both the distinction and the potential connection between the effects of chronic and acute stress. Given the similarities in biological and cognitive systems that are implicated in choking, there is clearly reason to believe that other species experience effects of pressure, and that there is a need for explicit focus on their responses to pressure. While pressure certainly may be implicitly involved in many comparative cognition studies (indeed, reward- and time-pressure are often present when testing other species), almost no research has isolated how that pressure influences cognitive performance and decision-making in a way that effectively isolates it from difficulty. This might be because pressure is an intensely experience-based phenomenon, and some past research in human subjects has relied heavily on self-report measures of pressure. Animals, of course, are unable to self-report internal experiences of pressure, making it challenging to consider pressure in non-human subjects. However, pressure has been correlated with physiological measures as well. Because animals show similar physiological responses to stress and similar cognitive abilities as humans, it follows that high-pressure situations may affect their cognitive systems in similar ways as they do in humans, and that biological correlates of the stress response might covary with performance in these high-pressure situations. However, to test this, we must design cognitive studies that manipulate pressure experimentally, to explore how pressure alone influences performance. You have to have a positive mind, you have to stand there and be tension-free. If you stand there and are worried about everything, it’s hard to swing. When I play my best, it’s free-flowing and relaxed, no tension – just focus and have a target, but you’re relaxed and your muscles can perform. There’s nothing worse than when you try to do something and it’s all tension and pressure and you can’t breathe properly.”How you think about your feelings and emotions is one aspect of self-talk, but there’s another kind that can also be highly counterproductive when you’re under pressure. One word that particularly raises a red flag is ‘should’, as in ‘I should be able to give this presentation easily’ or ‘I should be able to finish this project tonight.’ This word is loaded with expectations and pressure, and it prevents you from being open to all the options in front of you. We must consider people’s skills, capabilities, experience and personality traits because this is a perception of pressure, not an objective measure. We should also consider the other pressures everyone of us has in our lives. Pressure is cumulative and it doesn’t respect work-life boundaries. When pressure is very high and sustained, we might enter the dangerous, burnout zone. In crisis, we experience exhaustion from chronic stress. Our body perpetually draws on its survival mechanisms as it believes it is in physical danger and the ‘fight or flight’ response takes over. Adrenaline and cortisol are now running the show and we have little chance of focussing on complex mental tasks or making good decisions. We need immediate rest. He does not believe there is anything inevitable about choking – and that everyone can practise in a way that makes them less likely to choke. “Could I have dealt with that differently? Could I have had methods to slow myself down? I think I could.” Managers and employees need to understand and regulate pressure to improve performance and minimise the harmful effects of stress.

Harris’s book The Happiness Trap (2007) is the one I see most often recommended by psychologists to understand how to incorporate more acceptance, commitment and flexibility into your life. Donald was paralysed by anxiety – a classic symptom of choking. When he finally started to run, he was out by yards. South Africa were out of the competition.

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The boreout zone is red for a reason. Spending too long in that zone is not a good place to be. Long-term boredom can be very stressful, even though there’s negligible pressure. What to do about boreout You may sometimes find yourself in the boreout zone if your work is repetitive, easy and mundane with little opportunity for social interaction. Even varied work that you see as having little value can lead to boreout. When you’re under pressure, you might feel overwhelmed by your feelings and notice aggressive, unforgiving language bouncing around your mind, such as ‘I’m furious’ or ‘I’m terrified’. It’s as if the passengers on your bus are using very emotive language as they try to get your attention. Interpreting your feelings in this way can trigger your automatic fight-or-flight response, which evolved to help you survive danger, but is highly unhelpful to performance in many situations in modern life.